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Organization

PEDIATRIC COUNSELING CENTER, LLC

Active
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Organization

PEDIATRIC COUNSELING CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JODI TEN BROEKE (OWNER)
(269) 372-6500
Entity
Organization

Contact information

Practice address
950 N 10TH ST, SUITE 200, KALAMAZOO, MI 49009-6112
(269) 372-6500
(269) 372-6503
Mailing address
950 N 10TH ST, SUITE 200, KALAMAZOO, MI 49009-6112
(269) 372-6500
(269) 372-6503

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801081725
MI
235Z00000X
Speech-Language Pathologist

Other

Enumeration date
06/30/2008
Last updated
06/30/2008
About Stedi
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